Based on a range of social and economic factors, Mississippi is the worst state to live in. With the nation’s highest poverty rate of 22.0% and the lowest life expectancy of 74.5 years, economic factors have likely had an adverse effect on the quality of life of Mississippians. While health insurance coverage has increased dramatically across the nation in recent years, many Americans, especially those in low income families, remain uncovered. The typical household in Mississippi earns $40,593 annually, the lowest of all states and in stark contrast to the national annual household income of $55,775. The percentage of people without health insurance in Mississippi, at 12.7%, is sixth highest of all states.

The cost of living in Mississippi is the lowest in the nation, yet for most people it is nowhere near enough to offset the low incomes. On average, goods and services cost about 13% less in the state than across the nation.

Population declines are typically due in large part to weak economic conditions. The vast majority of states, even ones ranked poorly on this list, have growing populations. West Virginia’s population, on the other hand, actually shrank slightly over the last five years. This appears to be the case in West Virginia, where the unemployment rate of 6.0% is fourth highest of all states, and the poverty rate of 17.9% is among the highest in the nation.

Unlike many states with a poorly-rated quality of life, West Virginia’s violent crime rate is below average. For every 100,000 state residents, 338 violent incidents were reported in 2015, lower than the national violent crime rate of 373 per 100,000 people.

Roughly one in five Louisiana residents live at or below the poverty line, the third highest poverty rate of all states. Financial struggles across the state are likely exacerbated by an inadequate job market. Louisiana’s 6.3% unemployment rate is nearly the highest in the country and well above the 4.9% nationwide rate. Most Americans have health insurance through their employers, and a lack of jobs likely contributes to the higher than average uninsured rate. Nearly 12% of Louisiana residents are without health insurance, a far larger share than the 9.4% uninsured rate nationwide.

High crime rates across the state also detract from the overall quality of life. There were 540 violent crimes — such as rape, murder, and robbery — for every 100,000 state residents last year, a higher share than in all but four other states.

Incomes are low in Arkansas. The typical household in the state earns only about $42,000 a year, nearly $14,000 less than the typical American household. Partially offsetting the lower incomes is the relatively low cost of living. Goods and services cost about 12.5% less across the state than they do on average nationwide. Still, 19.1% of Arkansas residents live in poverty, a higher poverty rate than in all but three other states.

People living in poverty are less likely to be able to afford healthy food regularly. In Arkansas, one-third of adults are obese and more than one in five adults report being in fair or poor health, each among the highest shares in the country. Life expectancy is only 75.8 years in Arkansas, nearly three years less than the average life expectancy across the United States.

Life expectancy at birth in Alabama is only 75.2 years, the lowest in the country after Mississippi. A low life expectancy is partially attributable to pervasive unhealthy habits. More than one in five adults in Alabama are smokers and more than a third are obese, each among the largest such shares in the country.

Alabama residents are also more likely to be facing financial hardship than most Americans. The typical household in Alabama earns only $44,765 a year, roughly $11,000 less than the national median income. Similarly, 18.5% of state residents live in poverty, far greater than the national poverty rate of 14.7%.